Dr. Ahmed Eczema is a skin condition characterized by relentless itching, redness, dryness, and discomfort that affects millions worldwide.
Many find living with eczema a daily challenge because one needs the right combination of treatments to keep symptoms and flare-ups at bay.
There are multiple treatments for eczema, but therapy often starts with topical corticosteroids. On the other hand, Dupixent (dupilumab) is considered the most potent treatment option for the management of eczema.
Although they share the common purpose of symptom relief, significant differences exist in their mode of action, efficacy, side effects, and long-term suitability.
This article will discuss what really makes Dupixent different from steroid creams on the basis of efficacy and side effects.
Dupixent for Eczema
Dupixent is a biologic for the treatment of patients with moderate-to-severe eczema who are inadequately controlled with topical treatments.
It acts by targeting specific immune pathways, interleukin-4 and interleukin-13, which drive the inflammation process in eczema.
| Advantages | Disadvantages: |
| It targets the root cause of inflammation in eczema. | High price and low accessibility without insurance. |
| Effective in severe cases that are not responding to topical therapies. | Most require repeated injections, which may be inconvenient. |
| It can be safely used for long periods under medical supervision. | Possible side effects include conjunctivitis and injection site reactions. |
Prednisone Creams for Eczema
Steroid creams, also known as topical corticosteroids, are among the most common eczema treatments. They suppress inflammation and reduce immune system activity in the skin.
Application: Steroid creams are applied to the affected areas and range from mild, such as hydrocortisone cream, to very potent, such as clobetasol cream or ointment.
Effectiveness: Steroid creams are very effective in reducing redness, itchiness, and swelling during flare-ups.
Cost and Accessibility: These treatments are widely available, with many mild formulations over the counter.
| Advantages: | Disadvantages: |
| Quick alleviation of acute symptoms | Long-term use may lead to skin thinning, stretch marks, and changes in skin pigmentation. |
| Easy to use and widely available | Risk of rebound flares if it is stopped abruptly after long-term use. |
| Relatively inexpensive compared to biologic treatments like Dupixent | Does not impact the root immune dysfunction of eczema. |
Comparing Dupixent and Steroid Creams
| Category | Dupixent | Steroid Creams |
| Mechanism | Blocks IL-4 and IL-13 pathways | Reduces inflammation broadly |
| Administration | Injectable (bi-weekly) | Topical application |
| Effectiveness | Best for moderate-to-severe cases | Best for mild-to-moderate cases |
| Side Effects | Mild conjunctivitis, injection site reactions | Skin thinning, stretch marks |
| Cost | High, often requires insurance | Affordable, OTC options available |
| Long-Term Use | Safe with monitoring | Risk of side effects over time |
| Accessibility | Prescription required, less common | Widely available, OTC options |
Dupixent Vs Prednisone Creams – Efficacy
Dupixent is mainly used to treat moderate-to-severe eczema, particularly for patients with insufficient symptom relief using topical therapy.
The unique mechanism of action would suggest that it is very effective in treating chronic inflammation and generally improves quality of life.
Many report significant improvement in symptoms over an extended period with less reliance on other medications.
According to one review, 16 weeks of dupilumab therapy resulted in a 50% improvement in EASI scores of almost 85.1% of patients, and 26.8% of patients out of a total of 3,303 reached 90% improvement. The study reported that the most common side effect of dupilumab therapy was conjunctivitis. [Ref]
Another study assessing the long-term effects of dupilumab suggested that in 52 weeks, dupilumab therapy led to an 88.1% decrease in EASI scores. [Ref]
A cohort study investigated the combination therapy of dupilumab and topical corticosteroids in 95 patients; the study reported greater symptom relief with combined therapy than compared with dupilumab alone. [Ref]
Steroid creams are more effective for mild to moderate eczema or even flare-ups in the short term. They act faster but do not deal with the roots of eczema, hence allowing symptoms to return when such medication is stopped.
Duppilumab Vs Prednisone Creams: Safety and Side Effects
Both treatments are adequate but not without some potential side effects.
- Dupixent:
- The common side effects are injection site reactions, conjunctivitis, and allergic reactions. These are very rare. Generally, the drug is well-tolerated and safe for long-term use.
- Steroid Creams:
- Long-term use of steroid creams can lead to skin thinning, stretch marks, and vulnerability to infections. Overuse can also cause systemic absorption, with systemic effects like adrenal suppression.
Cost and Accessibility
Another glaring difference between Dupixent and steroid creams is cost. Treatment with Dupixent costs tens of thousands of dollars a year, and thus, it is costly. Much of the cost is generally covered by insurance, but prior authorization is usually required, which can delay access.
On the other hand, steroid creams are inexpensive and widely available. Many mild formulations can be bought over the counter, making them fairly accessible for most people.
Long-Term Use of Dupilumab vs Prednisone:
Because of its safety profile, treatment with Dupixent can be continued for as long as the dermatologist sees fit. It soothes and targets the root cause of eczema, thus reducing the need for other therapeutic options
Steroid creams are usually not recommended for longer periods as prolonged use is likely to cause skin damage and other complications; hence, it’s best to use them judiciously and only under medical advice.
Conclusion
While Dupixent and steroid creams are helpful options for managing eczema, they serve different needs.
Dupixent will be ideal for patients with severe eczema because of its targeted action and long-term benefits; steroid creams are quite practical for mild cases because of their relatively low cost and easy accessibility.
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